Comparison of two-view digital breast tomosynthesis to three-view digital mammography in a simulated screening setting

BackgroundAlthough digital breast tomosynthesis (DBT) may be an effective breast cancer screening modality, alternatives are important to explore as this technique presents some challenges for population screening implementation.PurposeTo compare the detection performance of three-view (craniocaudal [CC] + mediolateral oblique [MLO] + mediolateral/lateromedial [ML/LM]) digital mammography (DM) to two-view (CC + MLO) DBT.Material and MethodsIn this institutional review board-approved study, recalled screening DBT exams from 3 March 2014 to 31 March 2015 with a ML/LM view acquired within 30 days were retrospectively reviewed for detection of breast cancer. Six radiologists blinded to outcomes evaluated two-view DBT, which included DM and tomosynthesis images, and three-view DM. Probability of malignancy and a BI-RADS score were assigned. Primary outcomes were area under the receiver operating characteristic curve (AUC) and benign and malignant recall rates.ResultsThe cohort included 121 cases: 37% were mali...